INS and major depressive disorder: The deterioration of sexual life quality and the increase in depression levels impaired both marital satisfaction and quality of life.[22,50] These 2 parameters, which negatively affected each other, also negatively affected blood glucose monitoring and HbA1c results measured in 3-month periods in women with diabetes.[57] Impaired insulin regulation in women with diabetes had negative consequences for body image.[17,47,51] All these were causing women with diabetes to experience snowballing psychological and sexual problems and impair the management of diabetes.